Healthcare Provider Details

I. General information

NPI: 1801003421
Provider Name (Legal Business Name): WATERFORD TOWNSHIP EMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 A AVE
ATCO NJ
08004-2434
US

IV. Provider business mailing address

192 A AVE
ATCO NJ
08004-2434
US

V. Phone/Fax

Practice location:
  • Phone: 856-306-6525
  • Fax: 856-767-3660
Mailing address:
  • Phone: 856-767-2236
  • Fax: 856-767-3660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberWATERF015
License Number StateNJ

VIII. Authorized Official

Name: MR. WILLIAM GARDNER
Title or Position: CHIEF
Credential:
Phone: 856-767-2236